Pseudoepitheliomatous keratotic and micaceous balanitis pathology

Introduction

Pseudoepitheliomatous keratotic and micaceous balanitis is a coronal balanitis that gradually takes on a silvery white appearance due to mica-like crusts and keratotic horny masses on the glans.

Histology of pseudoepitheliomatous keratotic and micaceous balanitis

In pseudoepitheliomatous keratotic and micaceous balanitis, the histology shows acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia with no cytological atypia (figures 1–3). There are non-specific dermal infiltrates.

Figure 1

Figure 2

Figure 3

Special studies for pseudoepitheliomatous keratotic and micaceous balanitis

A PAS stain is useful to exclude a fungal infection.

Differential diagnosis for pseudoepitheliomatous keratotic and micaceous balanitis

Other diagnoses to be considered include:

• Squamous cell carcinoma — this shows cytologic atypia. A biopsy is often needed to rule out dysplasia or carcinoma.